Public Health Implications and Possible Sources of Lead (Pb) as a Contaminant of Poorly Regulated Kratom Products in the United States

Abstract

Kratom (Mitragyna speciosa) is a tropical tree that is indigenous to Southeast Asia. Kratom leaf products have been used in traditional folk medicine for their unique combination of stimulant and opioid-like effects. Kratom is being increasingly used in the West for its reputed benefits in the treatment of pain, depression, and opioid use disorder (OUD). Recent studies from the United States Food and Drug Administration (FDA, Silver Spring, MD, USA) and our laboratory have shown that many kratom products being sold in the United States are contaminated with potentially hazardous levels of lead (Pb). In this commentary, we discuss the public health implications of the presence of Pb in kratom products, particularly as they relate to the predicted levels of Pb exposure among kratom users. We also considered the specific toxic effects of Pb and how they might relate to the known physiologic and toxicologic effects of kratom. Finally, we consider the possible sources of Pb in kratom products and suggest several areas for research on this issue.

Research and publication gaps on kratom and kratom products: a scoping review of current literature

“…Additionally, cultivation, harvesting, and processing of kratom plant material in Southeast Asian countries and importation, manufacture, and trade of kratom-derived products in the United States are currently not subjected to rigorous regulatory health and safety oversight or standardization. Consequently, consumers in the United States and in Southeast Asian countries are consuming products with not fully known chemical content, that can be contaminated [35,36,70] or adulterated [71,72], and may also vary in chemical content and potency from batch to batch. As a result, survey results based on self-reported effects of consuming products with unknown and inconsistent chemical content cannot offer unequivocal evidence concerning the health and safety profiles of such products.…”